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Article ; Online: Operative Time is Associated With Postoperative Complications After Pulmonary Lobectomy.

de Angelis, Paolo / Tan, Kay See / Chudgar, Neel P / Dycoco, Joseph / Adusumilli, Prasad S / Bains, Manjit S / Bott, Matthew J / Downey, Robert J / Huang, James / Isbell, James M / Molena, Daniela / Park, Bernard J / Rusch, Valerie W / Sihag, Smita / Jones, David R / Rocco, Gaetano

Annals of surgery

2022 Volume 278, Issue 6, Page(s) e1259–e1266

Abstract: Objective: To investigate the association between operative time and postoperative outcomes.: Background: The association between operative time and morbidity after pulmonary lobectomy has not been characterized fully.: Methods: Patients who ... ...

Abstract	Objective: To investigate the association between operative time and postoperative outcomes. Background: The association between operative time and morbidity after pulmonary lobectomy has not been characterized fully. Methods: Patients who underwent pulmonary lobectomy for primary lung cancer at our institution from 2010 to 2018 were reviewed. Exclusion criteria included clinical stage ≥IIb disease, conversion to thoracotomy, and previous ipsilateral lung treatment. Operative time was measured from incision to closure. Relationships between operative time and outcomes were quantified using multivariable mixed-effects models with surgeon-level random effects. Results: In total, 1651 patients were included. The median age was 68 years (interquartile range, 61-74), and 63% of patients were women. Median operative time was 3.2 hours (interquartile range, 2.7-3.8) for all cases, 3.0 hours for open procedures, 3.3 hours for video-assisted thoracoscopies, and 3.3 hours for robotic procedures ( P =0.0002). Overall, 488 patients (30%) experienced a complication; 77 patients (5%) had a major complication (grade ≥3), and 5 patients (0.3%) died within 30 days of discharge. On multivariable analysis, operative time was associated with higher odds of any complication [odds ratio per hour, 1.37; 95% confidence interval (CI), 1.20-1.57; P <0.0001] and major complication (odds ratio per hour, 1.41; 95% CI, 1.21-1.64; P <0.0001). Operative time was also associated with longer hospital length of stay (β, 1.09; 95% CI, 1.04-1.14; P =0.001). Conclusions: Longer operative time was associated with worse outcomes in patients who underwent lobectomy. Operative time is a potential risk factor to consider in the perioperative phase.
MeSH term(s)	Humans ; Female ; Aged ; Male ; Lung Neoplasms/surgery ; Operative Time ; Retrospective Studies ; Pneumonectomy/adverse effects ; Pneumonectomy/methods ; Postoperative Complications/etiology ; Lung ; Thoracic Surgery, Video-Assisted/adverse effects ; Thoracic Surgery, Video-Assisted/methods ; Length of Stay
Language	English
Publishing date	2022-09-05
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000005696
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Article ; Online: Time-varying analysis of readmission and mortality during the first year after pneumonectomy.

Jones, Gregory D / Tan, Kay See / Caso, Raul / Dycoco, Joseph / Park, Bernard J / Bott, Matthew J / Molena, Daniela / Huang, James / Isbell, James M / Bains, Manjit S / Jones, David R / Rocco, Gaetano

The Journal of thoracic and cardiovascular surgery

2020 Volume 160, Issue 1, Page(s) 247–255.e5

Abstract: Objectives: Mortality rates of 5% to 10% after pneumonectomy have remained constant during the last decade. To understand the patterns of outcomes after pneumonectomy, we investigated the time-varying risks of readmission and death during the first ... ...

Abstract	Objectives: Mortality rates of 5% to 10% after pneumonectomy have remained constant during the last decade. To understand the patterns of outcomes after pneumonectomy, we investigated the time-varying risks of readmission and death during the first postoperative year and examined the contributions of specific causes to these patterns over time. Methods: We retrospectively reviewed all pneumonectomies for lung cancer at our institution from 2000 to 2018. The time-varying instantaneous risk of all-cause readmission and mortality up to 1 year after pneumonectomy was estimated using parametric analyses and was repeated for each primary cause of readmission (oncologic, infectious, pulmonary, cardiac, or other) and death (oncologic or nononcologic). Results: In our cohort of 355 patients who underwent pneumonectomy, risk of readmission was highest immediately after discharge and was halved by 14 days. This risk reached a nadir and remained constant from 4 to 8 months, after which it gradually increased. Pulmonary causes accounted for most readmissions within 90 days, after which oncologic causes predominated. Likewise, the overall risk of death was highest immediately after surgery, was halved by 7 days, reached a nadir at 90 days, and then increased throughout the remainder of the first year. All deaths during the first 90 days after surgery were due to nononcologic causes. Conclusions: Nononcologic causes of readmission and death predominate in the first 90 days after pneumonectomy, after which oncologic causes prevail. We also identify specific causes that pose the highest risk of readmission immediately after discharge. Efforts are warranted to define the effects of specific causes of readmission on overall mortality after pneumonectomy.
MeSH term(s)	Aged ; Female ; Humans ; Lung Neoplasms/mortality ; Lung Neoplasms/surgery ; Male ; Middle Aged ; Patient Readmission/statistics & numerical data ; Pneumonectomy/adverse effects ; Pneumonectomy/mortality ; Postoperative Complications/mortality ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2020-03-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	3104-5
ISSN	1097-685X ; 0022-5223
ISSN (online)	1097-685X
ISSN	0022-5223
DOI	10.1016/j.jtcvs.2020.02.086
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Article ; Online: Prognostic factors following complete resection of non-superior sulcus lung cancer invading the chest wall.

Jones, Gregory D / Caso, Raul / No, Jae Seong / Tan, Kay See / Dycoco, Joseph / Bains, Manjit S / Rusch, Valerie W / Huang, James / Isbell, James M / Molena, Daniela / Park, Bernard J / Jones, David R / Rocco, Gaetano

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

2020 Volume 58, Issue 1, Page(s) 78–85

Abstract: Objectives: Locally advanced non-small-cell lung cancer (NSCLC) with chest wall invasion carries a high risk of recurrence and portends poor survival (30-40% and 20-50%, respectively). No studies have identified prognostic factors in patients who ... ...

Abstract	Objectives: Locally advanced non-small-cell lung cancer (NSCLC) with chest wall invasion carries a high risk of recurrence and portends poor survival (30-40% and 20-50%, respectively). No studies have identified prognostic factors in patients who underwent R0 resection for non-superior sulcus NSCLC. Methods: A retrospective review was conducted for all chest wall resections for NSCLC from 2004 to 2018. Patients with superior sulcus tumours, partial (<1 rib) or incomplete (R1/R2) resection or distant metastasis were excluded. Disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Cox proportional hazards modelling was used to determine factors associated with DFS and OS. Results: A total of 100 patients met inclusion criteria. Seventy-three (73%) patients underwent induction therapy, and all but 12 (16%) patients experienced a partial radiological response. A median of 3 ribs was resected (range 1-7), and 67 (67%) patients underwent chest wall reconstruction. The 5-year DFS and OS were 36% and 45%, respectively. Pathological N2 status [hazard ratio (HR) 3.12, confidence interval (CI) 1.56-6.25; P = 0.001], intraoperative blood transfusion (HR 2.24, CI 1.28-3.92; P = 0.005) and preoperative forced vital capacity (per % forced vital capacity, HR 0.97, CI 0.96-0.99; P = 0.013) were associated with DFS. Increasing pathological stage, lack of radiological response to induction therapy (HR 7.35, CI 2.35-22.99; P = 0.001) and cardiovascular comorbidity (HR 2.43, CI 1.36-4.36; P = 0.003) were associated with OS. Conclusions: We demonstrate that blood transfusion and forced vital capacity are associated with DFS after R0 resection for non-superior sulcus NSCLC, while radiological response to induction therapy greatly influences OS. We confirm that pathological nodal status and pathological stage are reproducible determinants of DFS and OS, respectively.
MeSH term(s)	Carcinoma, Non-Small-Cell Lung/diagnostic imaging ; Carcinoma, Non-Small-Cell Lung/pathology ; Carcinoma, Non-Small-Cell Lung/surgery ; Humans ; Lung Neoplasms/pathology ; Lung Neoplasms/surgery ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Thoracic Wall/diagnostic imaging ; Thoracic Wall/pathology ; Thoracic Wall/surgery
Language	English
Publishing date	2020-05-28
Publishing country	Germany
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	639293-3
ISSN	1873-734X ; 1010-7940 ; 1567-4258
ISSN (online)	1873-734X
ISSN	1010-7940 ; 1567-4258
DOI	10.1093/ejcts/ezaa027
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Article ; Online: How Effective Is Neoadjuvant Therapy Followed by Surgery for Pathologic Single-Station N2 Non-Small Cell Lung Cancer?

Keshava, Hari B / Tan, Kay See / Dycoco, Joseph / Livschitz, Jennifer / Bott, Matthew J / Huang, James / Rusch, Valerie W / Isbell, James M / Molena, Daniela / Bains, Manjit S / Jones, David R / Rocco, Gaetano

Seminars in thoracic and cardiovascular surgery

2020 Volume 33, Issue 1, Page(s) 206–216

Abstract: The optimal treatment strategy for pathologic single-station N2 (pN2a1) non-small cell lung cancer (NSCLC)-surgery first followed by adjuvant treatment (SF) or neoadjuvant therapy followed by surgery (NS)-remains unclear. We compared disease-free ... ...

Abstract	The optimal treatment strategy for pathologic single-station N2 (pN2a1) non-small cell lung cancer (NSCLC)-surgery first followed by adjuvant treatment (SF) or neoadjuvant therapy followed by surgery (NS)-remains unclear. We compared disease-free survival (DFS) and overall survival (OS) after NS versus SF for pN2a1 NSCLC. We retrospectively identified patients with pN2a1 NSCLC resected between 2000 and 2018. Patients in the SF group had cN0 disease and were treated with surgery before adjuvant chemotherapy; patients in the NS group had known preoperative nodal disease, cN2 disease, and were treated with neoadjuvant therapy before surgery. The matching-weights procedure was applied to generate a cohort with similar characteristics between groups. DFS and OS were calculated using the Kaplan-Meier approach and compared between groups using weighted log-rank test and Cox proportional hazards models. We identified 227 patients with pN2a1 disease: 121 treated with SF and 106 with NS. After the matching-weights procedure, 5- and 10-year DFS were 45% and 27% for SF versus 26% and 21% for NS (log-rank P = 0.056; hazard ratio [HR], 1.61; 95% confidence interval [CI], 0.98-2.65); 5- and 10-year OS were 49% and 30% for SF versus 43% and 20% for NS (log-rank P = 0.428; HR, 1.24; 95% CI, 0.67-2.28). SF and NS for pN2a1 NSCLC resulted in similar survival. A study comparing SF for known preresectional pN2a1 with occult pN2a1 disease could be a next step. Further investigation of SF for known N2a1 versus occult pN2a1 disease could power a clinical trial focused on N2a NSCLC.
MeSH term(s)	Carcinoma, Non-Small-Cell Lung/pathology ; Carcinoma, Non-Small-Cell Lung/surgery ; Humans ; Lung Neoplasms/pathology ; Lung Neoplasms/surgery ; Neoadjuvant Therapy/adverse effects ; Neoplasm Staging ; Retrospective Studies
Language	English
Publishing date	2020-08-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	1038278-1
ISSN	1532-9488 ; 1043-0679
ISSN (online)	1532-9488
ISSN	1043-0679
DOI	10.1053/j.semtcvs.2020.08.006
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Article ; Online: Shape-Sensing Robotic-Assisted Bronchoscopy in the Diagnosis of Pulmonary Parenchymal Lesions.

Kalchiem-Dekel, Or / Connolly, James G / Lin, I-Hsin / Husta, Bryan C / Adusumilli, Prasad S / Beattie, Jason A / Buonocore, Darren J / Dycoco, Joseph / Fuentes, Paige / Jones, David R / Lee, Robert P / Park, Bernard J / Rocco, Gaetano / Chawla, Mohit / Bott, Matthew J

Chest

2021 Volume 161, Issue 2, Page(s) 572–582

Abstract: Background: The landscape of guided bronchoscopy for the sampling of pulmonary parenchymal lesions is evolving rapidly. Shape-sensing robotic-assisted bronchoscopy (ssRAB) recently was introduced as means to allow successful sampling of traditionally ... ...

Abstract	Background: The landscape of guided bronchoscopy for the sampling of pulmonary parenchymal lesions is evolving rapidly. Shape-sensing robotic-assisted bronchoscopy (ssRAB) recently was introduced as means to allow successful sampling of traditionally challenging lesions. Research question: What are the feasibility, diagnostic yield, determinants of diagnostic sampling, and safety of ssRAB in patients with pulmonary lesions? Study design and methods: Data from 131 consecutive ssRAB procedures performed at a US-based cancer center between October 2019 and July 2020 were captured prospectively and analyzed retrospectively. Definitions of diagnostic procedures were based on prior standards. Associations of procedure- and lesion-related factors with diagnostic yield were examined by univariate and multivariate generalized linear mixed models. Results: A total of 159 pulmonary lesions were targeted during 131 ssRAB procedures. The median lesion size was 1.8 cm, 59.1% of lesions were in the upper lobe, and 66.7% of lesions were beyond a sixth-generation airway. The navigational success rate was 98.7%. The overall diagnostic yield was 81.7%. Lesion size of ≥ 1.8 cm and central location were associated significantly with a diagnostic procedure in the univariate analysis. In the multivariate model, lesions of ≥ 1.8 cm were more likely to be diagnostic compared with lesions < 1.8 cm, after adjusting for lung centrality (OR, 12.22; 95% CI, 1.66-90.10). The sensitivity and negative predictive value of ssRAB for primary thoracic malignancies were 79.8% and 72.4%, respectively. The overall complication rate was 3.0%, and the pneumothorax rate was 1.5%. Interpretation: This study was the first to provide comprehensive evidence regarding the usefulness and diagnostic yield of ssRAB in the sampling of pulmonary parenchymal lesions. ssRAB may represent a significant advancement in the ability to access and sample successfully traditionally challenging pulmonary lesions via the bronchoscopic approach, while maintaining a superb safety profile. Lesion size seems to remain the major predictor of a diagnostic procedure.
MeSH term(s)	Aged ; Bronchoscopy/methods ; Feasibility Studies ; Female ; Humans ; Lung Neoplasms/diagnosis ; Lung Neoplasms/pathology ; Male ; Middle Aged ; Retrospective Studies ; Robotics ; Sensitivity and Specificity
Language	English
Publishing date	2021-08-09
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2021.07.2169
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Article ; Online: Postinduction therapy pulmonary function retesting is necessary before surgical resection for non-small cell lung cancer.

Connolly, James G / Fiasconaro, Megan / Tan, Kay See / Cirelli, Michael A / Jones, Gregory D / Caso, Raul / Mansour, Daniel E / Dycoco, Joseph / No, Jae Seong / Molena, Daniela / Isbell, James M / Park, Bernard J / Bott, Matthew J / Jones, David R / Rocco, Gaetano

The Journal of thoracic and cardiovascular surgery

2021 Volume 164, Issue 2, Page(s) 389–397.e7

Abstract: Objective: Pretreatment-predicted postoperative diffusing capacity of the lung for carbon monoxide (DLCO) has been associated with operative mortality in patients who receive induction therapy for resectable non-small cell lung cancer (NSCLC). It is ... ...

Abstract	Objective: Pretreatment-predicted postoperative diffusing capacity of the lung for carbon monoxide (DLCO) has been associated with operative mortality in patients who receive induction therapy for resectable non-small cell lung cancer (NSCLC). It is unknown whether a reduction in pulmonary function after induction therapy and before surgery affects the risk of morbidity or mortality. We sought to determine the relationship between induction therapy and perioperative outcomes as a function of postinduction pulmonary status in patients who underwent surgical resection for NSCLC. Methods: We retrospectively reviewed data for 1001 patients with pathologic stage I, II, or III NSCLC who received induction therapy before lung resection. Pulmonary function was defined according to American College of Surgeons Oncology Group major criteria: DLCO ≥50% = normal; DLCO <50% = impaired. Patients were categorized into 5 subgroups according to combined pre- and postinduction DLCO status: normal-normal, normal-impaired, impaired-normal, impaired-impaired, and preinduction only (without postinduction pulmonary function test measurements). Multivariable logistic regression was used to quantify the relationship between DLCO categories and dichotomous end points. Results: In multivariable analysis, normal-impaired DLCO status was associated with an increased risk of respiratory complications (odds ratio, 2.29 [95% CI, 1.12-4.49]; P = .02) and in-hospital complications (odds ratio, 2.83 [95% CI, 1.55-5.26]; P < .001). Type of neoadjuvant therapy was not associated with an increased risk of complications, compared with conventional chemotherapy. Conclusions: Reduced postinduction DLCO might predict perioperative outcomes. The use of repeat pulmonary function testing might identify patients at higher risk of morbidity or mortality.
MeSH term(s)	Carbon Monoxide/metabolism ; Carcinoma, Non-Small-Cell Lung/pathology ; Humans ; Lung ; Lung Neoplasms/pathology ; Pulmonary Diffusing Capacity ; Respiratory Function Tests ; Retrospective Studies
Chemical Substances	Carbon Monoxide (7U1EE4V452)
Language	English
Publishing date	2021-12-23
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	3104-5
ISSN	1097-685X ; 0022-5223
ISSN (online)	1097-685X
ISSN	0022-5223
DOI	10.1016/j.jtcvs.2021.12.030
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Article ; Online: Propensity-matched Analysis Demonstrates Long-term Risk of Respiratory and Cardiac Mortality After Pneumonectomy Compared With Lobectomy for Lung Cancer.

Jones, Gregory D / Caso, Raul / Tan, Kay See / Dycoco, Joseph / Adusumilli, Prasad S / Bains, Manjit S / Downey, Robert J / Huang, James / Isbell, James M / Molena, Daniela / Park, Bernard J / Rocco, Gaetano / Rusch, Valerie W / Sihag, Smita / Jones, David R / Bott, Matthew J

Annals of surgery

2020 Volume 275, Issue 4, Page(s) 793–799

Abstract: Objective: We sought to quantify and characterize long-term consequences of pneumonectomy, with particular attention to nononcologic mortality.: Summary of background data: Pneumonectomy is associated with profound changes in cardiopulmonary ... ...

Abstract	Objective: We sought to quantify and characterize long-term consequences of pneumonectomy, with particular attention to nononcologic mortality. Summary of background data: Pneumonectomy is associated with profound changes in cardiopulmonary physiology. Studies of long-term outcomes after pneumonectomy typically report generalized measures, such as disease-free and overall survival. Methods: Patients undergoing lobectomy or pneumonectomy for lung cancer at our institution from 2000 to 2018 were reviewed. Propensity-score matching was performed for 12 clinicopathologic factors. Ninety-day complications and deaths were compared. Five-year cumulative incidence of oncologic and nononcologic mortality were compared using competing risks approaches. Results: From 3339 lobectomy and 355 pneumonectomy patients identified, we derived 318 matched pairs. At 90 days, rates of overall complications were similar (46% for pneumonectomy vs 43% for lobectomy; P = 0.40), but rates of major complications (21% vs 13%; P = 0.005) and deaths (6.9% vs 1.9%; P = 0.002) were higher the pneumonectomy cohort. The cumulative incidence of oncologic mortality was not significantly different between cohorts (P = 0.9584). However, the cumulative incidence of nononcologic mortality was substantially higher in the pneumonectomy cohort for both date of surgery and 1-year landmark analyses (P < 0.0001 and P = 0.0002, respectively). Forty-five pneumonectomy patients (18%) died of nononcologic causes 1-5 years after surgery; pneumonia (n = 21) and myocardial infarction (n = 10) were the most common causes. In pneumonectomy patients, preexisting cardiac comorbidity and low diffusion capacity of the lungs for carbon monoxide were predictive of nononcologic mortality. Conclusions: Compared to lobectomy, excess mortality after pneumonectomy extends beyond 1 year and is driven primarily by nononcologic causes. Pneumonectomy patients require lifelong monitoring and may benefit from expeditious assessment and intervention at the initial signs of illness.
MeSH term(s)	Humans ; Lung Neoplasms ; Pneumonectomy/adverse effects ; Propensity Score ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2020-06-03
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000004065
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Article ; Online: Intraoperative opioid exposure, tumour genomic alterations, and survival differences in people with lung adenocarcinoma.

Connolly, James G / Tan, Kay See / Mastrogiacomo, Brooke / Dycoco, Joseph / Caso, Raul / Jones, Gregory D / McCormick, Patrick J / Sanchez-Vega, Francisco / Irie, Takeshi / Scarpa, Joseph R / Gupta, Hersh V / Adusumilli, Prasad S / Rocco, Gaetano / Isbell, James M / Bott, Matthew J / Fischer, Gregory W / Jones, David R / Mincer, Joshua S

British journal of anaesthesia

2021 Volume 127, Issue 1, Page(s) 75–84

Abstract: Background: Opioids have been linked to worse oncologic outcomes in surgical patients. Studies in certain cancer types have identified associations between survival and intra-tumoural opioid receptor gene alterations, but no study has investigated ... ...

Abstract	Background: Opioids have been linked to worse oncologic outcomes in surgical patients. Studies in certain cancer types have identified associations between survival and intra-tumoural opioid receptor gene alterations, but no study has investigated whether the tumour genome interacts with opioid exposure to affect survival. We sought to determine whether intraoperative opioid exposure is associated with recurrence-specific survival and overall survival in early-stage lung adenocarcinoma, and whether selected tumour genomics are associated with this relationship. Associations between ketamine and dexmedetomidine and outcomes were also studied. Methods: Surgical patients (N=740) with pathological stage I-III lung adenocarcinoma and next-generation sequencing data were retrospectively reviewed from a prospectively maintained database. Results: On multivariable analysis, ketamine administration was protective for recurrence-specific survival (hazard ratio = 0.44, 95% confidence interval 0.24-0.80; P=0.007), compared with no adjunct. Higher intraoperative oral morphine milligram equivalents were significantly associated with worse overall survival (hazard ratio=1.09/10 morphine milligram equivalents, 95% confidence interval 1.02-1.17; P=0.010). Significant interaction effects were found between morphine milligram equivalents and fraction genome altered and morphine milligram equivalents and CDKN2A, such that higher fraction genome altered or CDKN2A alterations were associated with worse overall survival at higher morphine milligram equivalents (P=0.044 and P=0.052, respectively). In contrast, alterations in the Wnt (P=0.029) and Hippo (P=0.040) oncogenic pathways were associated with improved recurrence-specific survival at higher morphine milligram equivalents, compared with unaltered pathways. Conclusions: Intraoperative opioid exposure is associated with worse overall survival, whereas ketamine exposure is associated with improved recurrence-specific survival in patients with early-stage lung adenocarcinoma. This is the first study to investigate tumour-specific genomic interactions with intraoperative opioid administration to modify survival associations.
MeSH term(s)	Adenocarcinoma of Lung/genetics ; Adenocarcinoma of Lung/mortality ; Adenocarcinoma of Lung/surgery ; Aged ; Analgesics, Opioid/administration & dosage ; Analgesics, Opioid/adverse effects ; Female ; Genomics/trends ; Humans ; Intraoperative Care/adverse effects ; Intraoperative Care/trends ; Lung Neoplasms/genetics ; Lung Neoplasms/mortality ; Lung Neoplasms/surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local/diagnosis ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/genetics ; Pain, Postoperative/prevention & control ; Prospective Studies ; Retrospective Studies ; Survival Rate/trends
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2021-06-17
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2021.03.030
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Article ; Online: Intraoperative ketorolac may interact with patient-specific tumour genomics to modify recurrence risk in lung adenocarcinoma: an exploratory analysis.

Connolly, James G / Scarpa, Joseph R / Gupta, Hersh V / Tan, Kay See / Mastrogiacomo, Brooke / Dycoco, Joseph / Caso, Raul / Jones, Gregory D / Sanchez-Vega, Francisco / Adusumilli, Prasad S / Rocco, Gaetano / Isbell, James M / Bott, Matthew J / Irie, Takeshi / McCormick, Patrick J / Fischer, Gregory W / Jones, David R / Mincer, Joshua S

British journal of anaesthesia

2021 Volume 127, Issue 3, Page(s) e82–e85

MeSH term(s)	Adenocarcinoma of Lung/genetics ; Adenocarcinoma of Lung/mortality ; Adenocarcinoma of Lung/pathology ; Adenocarcinoma of Lung/surgery ; Anti-Inflammatory Agents, Non-Steroidal/administration & dosage ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects ; Biomarkers, Tumor/genetics ; Gene Regulatory Networks ; Genomics ; Humans ; Intraoperative Care ; Ketorolac/administration & dosage ; Ketorolac/adverse effects ; Lung Neoplasms/genetics ; Lung Neoplasms/mortality ; Lung Neoplasms/pathology ; Lung Neoplasms/surgery ; NF-E2-Related Factor 2/genetics ; Neoplasm Recurrence, Local ; Pneumonectomy/adverse effects ; Pneumonectomy/mortality ; Proto-Oncogene Proteins c-mdm2/genetics ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome
Chemical Substances	Anti-Inflammatory Agents, Non-Steroidal ; Biomarkers, Tumor ; NF-E2-Related Factor 2 ; NFE2L2 protein, human ; MDM2 protein, human (EC 2.3.2.27) ; Proto-Oncogene Proteins c-mdm2 (EC 2.3.2.27) ; Ketorolac (YZI5105V0L)
Language	English
Publishing date	2021-07-14
Publishing country	England
Document type	Letter ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2021.05.032
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Article ; Online: Patterns of recurrence and second primary lung cancer in early-stage lung cancer survivors followed with routine computed tomography surveillance.

Lou, Feiran / Huang, James / Sima, Camelia S / Dycoco, Joseph / Rusch, Valerie / Bach, Peter B

The Journal of thoracic and cardiovascular surgery

2013 Volume 145, Issue 1, Page(s) 75–81; discussion 81–2

Abstract: Objective: At present, there is no consensus on the optimal strategy for follow-up care after curative resection for lung cancer. We sought to understand the patterns of recurrence and second primary lung cancer, and their mode of detection, after ... ...

Abstract	Objective: At present, there is no consensus on the optimal strategy for follow-up care after curative resection for lung cancer. We sought to understand the patterns of recurrence and second primary lung cancer, and their mode of detection, after resection for early-stage non-small cell lung cancer in patients who were followed by routine surveillance computed tomography scan. Methods: We reviewed the outcomes of consecutive patients who underwent resection for early-stage non-small cell lung cancer at Memorial Sloan-Kettering Cancer Center between 2004 and 2009. Results: A total of 1294 consecutive patients with early-stage non-small cell lung cancer underwent resection. The median length of follow-up was 35 months. Recurrence was diagnosed in 257 patients (20%), and second primary lung cancer was diagnosed in 91 patients (7%). The majority of new primary cancers (85 [93%]) were identified by scheduled routine computed tomography scan, as were a smaller majority of recurrences (157 [61%]). During the first 4 years after surgery, the risk of recurrence ranged from 6% to 10% per person-year but decreased thereafter to 2%. Conversely, the risk of second primary lung cancer ranged from 3% to 6% per person-year and did not diminish over time. Additional testing after false-positive surveillance computed tomography scan results was performed for 329 patients (25%), but only 4 of these patients (0.3%) experienced complications as a result of subsequent invasive diagnostic procedures. Conclusions: Almost all second primary cancers and the majority of recurrences were detected by post-therapeutic surveillance computed tomography scan. The risk of recurrence for early-stage non-small cell lung cancer survivors persisted during the first 4 years after resection, and vigilance in surveillance should be maintained.
MeSH term(s)	Aged ; Carcinoma, Non-Small-Cell Lung/diagnostic imaging ; Carcinoma, Non-Small-Cell Lung/mortality ; Carcinoma, Non-Small-Cell Lung/secondary ; Carcinoma, Non-Small-Cell Lung/surgery ; Early Detection of Cancer ; False Positive Reactions ; Female ; Humans ; Kaplan-Meier Estimate ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/mortality ; Lung Neoplasms/pathology ; Lung Neoplasms/surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local/diagnostic imaging ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/therapy ; Neoplasm Staging ; Neoplasms, Second Primary/diagnostic imaging ; Neoplasms, Second Primary/pathology ; Neoplasms, Second Primary/therapy ; New York City ; Pneumonectomy ; Predictive Value of Tests ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome
Language	English
Publishing date	2013-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	3104-5
ISSN	1097-685X ; 0022-5223
ISSN (online)	1097-685X
ISSN	0022-5223
DOI	10.1016/j.jtcvs.2012.09.030
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